Thread by @DusetzinaS

💊💊💊NEW TWEETORIAL 💊💊💊
This is about #PartD and #AuthorizedGenerics and how some generics aren't a very good deal for health plans, even if they provide savings to patients. With @profmikecarrier @NancyKeatingMD @AmeetSarpatwari. 1/7
jamanetwork.com/journals/jamai…

You might remember headlines like this one that were telling us about companies coming out with generic versions of their $$$$ brand-name drugs. We saw this for #insulin #hepatitisC and #epipen over the past few years. 2/7
nytimes.com/2019/03/04/hea…

These are "authorized generics" which are when a brand company takes off the brand name but the drug is exactly the same. In these cases, the generic product came out way before patents were expired. 3/7

Why might a company do this when they are the only game in town (no other generic competitors in sight)? Good question. 4/7
We explain it here: pubmed.ncbi.nlm.nih.gov/33492347/

One reason would be to relieve some political pressure about how much #drug list prices are climbing. In the cases above, these drugs have all been the focus of investigations in #Congress. They have high and growing list prices but also have big rebates. 5/7

We find that these drugs aren't a good deal for Medicare and plans because of how #PartD works. Plans would probably LOSE money if they offer an authorized generic over a brand because brand-name drug rebates are high. We show that even a TINY rebate would do in some cases. 6/7

These #authorizedgenerics don't really help lower Rx spending. #PartD plans should pick the drug with the lowest net price, but not make the patient pay more when they do! Redesigning #PartD could also fix this problem, too! 7/7

Many thanks to @Arnold_Ventures & @commonwealthfnd for funding and @JAMAInternalMed for publishing!